Abstract
Long-term follow-up studies of anxiety treatment have found that greater exposure to negative life events (NLEs) predicts poorer anxiety outcomes, but none have examined whether specific types of NLEs are differentially associated with child outcomes. This study examined the frequency of NLEs and whether specific types of NLEs were associated with increased risk of having an anxiety disorder 6.5 years post randomization. Participants were 319 adolescents and adults, ages 11 to 26 (M = 17), enrolled in Child/Adolescent Anxiety Multimodal Extended Long-term Study. At their first follow-up visit, participants completed a diagnostic interview and a 40-item Life Events Scale that reflected whether specific events occurred since their last post treatment assessment. Life events were categorized into domains (i.e., family, academic, health, and social) via researcher consensus. Participants reported having experienced an average of four NLEs. Participants with an anxiety disorder at follow-up were significantly more likely to have failed a grade in school (OR = 5.9) and experienced a negative change in acceptance by peers (OR = 4.9; ps < 0.001). After controlling for gender, age, race, and SES, a greater number of NLEs in the academic domain increased the odds of having an anxiety disorder at follow-up (OR = 2.4, p < 0.001). No other domains were predictive of disorder status at follow-up. Findings highlight the value of examining specific NLEs in relation to the long-term child anxiety outcomes.
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The authors wish to acknowledge the contributions of Brittany A. Gibby and all CAMELS PIs and staff that worked on the project.
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This work was supported by the National Institute of Mental Health through grants awarded to Dr. Golda Ginsburg (R01MH064003), Dr. Dara Sakolsky (R01MH064003), Dr. John Piacentini (R01MH64088), Dr. Anne Marie Albano (R01MH64092), Dr. Scott Compton (R01MH64107), and Dr. Philip Kendall (R01MH063747).
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Dr. Ginsburg has received support from NIMH and from the US Department of Education/Institute of Education Sciences and serves as a consultant for Syneos Health. Dr. Piacentini has received support from NIMH, the TLC Foundation for Body-Focused Repetitive Behaviors, the Tourette Association of America, the Pettit Family Foundation, and Pfizer Pharmaceuticals through the Duke University Clinical Research Institute Network. He has received royalties from Guilford Press and Oxford University Press. He has served on the speakers’ bureau of the Tourette Association of America, the International Obsessive-Compulsive Disorder Foundation, and the TLC Foundation for Body-Focused Repetitive Behaviors. Dr. Compton has received support from NIMH, NC GlaxoSmithKline Foundation, Pfizer, Neurocrine Biosciences, and Mursion, Inc. He has served as a consultant for Shire and Mursion, Inc. He has received honoraria from the Nordic Long-Term OCD Treatment Study Research Group and the Centre for Child and Adolescent Mental Health, Eastern and Southern Norway. He has served on the scientific advisory board of Tourette Association of America, Anxiety and Depression Association of America, and Mursion, Inc. He has presented expert testimony for Duke University. Dr. Kendall has received support from NIMH and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). He has received royalties from the sales of materials related to the treatment of anxiety disorders in youth (eg, Guilford Press; Workbook Publishing; Gyldendal Norsk; Gyldendal Akademisk). No other disclosure were reported.
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Casline, E.P., Ginsburg, G.S., Piacentini, J. et al. Negative Life Events as Predictors of Anxiety Outcomes: An Examination of Event Type. Res Child Adolesc Psychopathol 49, 91–102 (2021). https://doi.org/10.1007/s10802-020-00711-x
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DOI: https://doi.org/10.1007/s10802-020-00711-x